Reversal of experimental renovascular hypertension restores coronary microvascular function and architecture

Victor H. Urbieta-Caceres, Xiang Yang Zhu, Matthew E. Gibson, Frederic D. Favreau, Kyra Jordan, Amir Lerman, Lilach O Lerman

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background Hypertension (HTN) may lead to left ventricular hypertrophy and vascular dysfunction, which are independent factors for adverse cardiovascular outcomes. We hypothesized that decreased blood pressure by percutaneous transluminal renal angioplasty (PTRA) would improve the function and architecture of coronary microvessels, in association with decreased inflammation and fibrosis.MethodsThree groups of pigs were studied: normal, HTN, and HTN+PTRA. After 6 weeks of renovascular HTN, induced by placing a local-irritant coil in the renal artery, pigs underwent PTRA or sham. Four weeks later multidetector-computed tomography (CT) was used to assess systolic, diastolic, and microvascular function, and responses to adenosine. Microvascular architecture, oxygen sensors, inflammation, and fibrosis were then explored in cardiac tissue.ResultsPTRA successfully decreased blood pressure and left ventricular hypertrophy. Basal fractional vascular volume (FVV) was similar among the groups, but its response to adenosine was significantly attenuated in HTN, whereas microvascular permeability (MP) and response to adenosine were greater than normal. Both were restored by PTRA. These were accompanied by increased myocardial expression of hypoxia-inducible factor (HIF)-1α, inflammation, and microvascular remodeling, including increased density of epicardial microvessels (20-200νm), as well as cardiac diastolic dysfunction, all of which improved by reversal of HTN. However, PTRA only partially decreased myocardial fibrosis.ConclusionsReversal of early renovascular HTN improved coronary microvascular function and architecture and reversed myocardial hypertrophy and diastolic dysfunction, in association with decreased levels of myocardial ischemia and inflammation markers, underscoring the benefits of blood pressure normalization for preservation of cardiovascular function and structure.

Original languageEnglish (US)
Pages (from-to)458-465
Number of pages8
JournalAmerican Journal of Hypertension
Volume24
Issue number4
DOIs
StatePublished - Apr 2011

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Renovascular Hypertension
Angioplasty
Hypertension
Kidney
Adenosine
Inflammation
Fibrosis
Left Ventricular Hypertrophy
Blood Pressure
Microvessels
Blood Vessels
Swine
Hypoxia-Inducible Factor 1
Multidetector Computed Tomography
Irritants
Capillary Permeability
Renal Artery
Hypertrophy
Myocardial Ischemia
Oxygen

Keywords

  • blood pressure
  • hypertension
  • microvascular dysfunction
  • remodeling
  • renovascular hypertension

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Reversal of experimental renovascular hypertension restores coronary microvascular function and architecture. / Urbieta-Caceres, Victor H.; Zhu, Xiang Yang; Gibson, Matthew E.; Favreau, Frederic D.; Jordan, Kyra; Lerman, Amir; Lerman, Lilach O.

In: American Journal of Hypertension, Vol. 24, No. 4, 04.2011, p. 458-465.

Research output: Contribution to journalArticle

Urbieta-Caceres, Victor H. ; Zhu, Xiang Yang ; Gibson, Matthew E. ; Favreau, Frederic D. ; Jordan, Kyra ; Lerman, Amir ; Lerman, Lilach O. / Reversal of experimental renovascular hypertension restores coronary microvascular function and architecture. In: American Journal of Hypertension. 2011 ; Vol. 24, No. 4. pp. 458-465.
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